Emergency visit, high (level 4) at St. Mary Medical Center. CPT 99284.
What St. Mary Medical Center publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$1,733cash price (self-pay)
$4,127list price
$88.24–$12,480range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Noble IPA | Medicaid|< 21 | $88.24 |
| Noble IPA | Medicaid|> 21 | $88.24 |
| BCBS - Anthem | Medicaid|All Plans | $98.04 |
| HCLA | Medicaid|Preferred IPA < 21 | $98.04 |
| HCLA | Medicaid|Preferred IPA > 21 | $98.04 |
| Inland Empire Health Plan | Medicaid|All Plans | $98.04 |
| Partnership Health Plan | Medicaid|< 21 | $98.04 |
| Health Net | Medicaid|< 21 | $131 |
| Health Net | Medicaid|> 21 | $131 |
| Molina | Medicaid|All Plans | $137 |
| Kaiser | Medicaid|< 21 | $147 |
| Kaiser | Medicaid|> 21 | $147 |
| LA Care | Medicaid|All Plans | $404 |
| Blue Shield CA | Medicaid|All Plans | $490 |
| Care 1st | Medicaid|All Plans | $490 |
| HCLA | Commercial|Preferred IPA | $676 |
| LA Care | Commercial|All Plans | $676 |
| DHR | Medicaid|< 21 | $1,032 |
| DHR | Medicaid|> 21 | $1,032 |
| Healthcare Partners | Commercial|All Plans | $2,146 |
| Blue Shield CA | Commercial|Exchange | $2,393 |
| Cigna | Commercial|All Other Plans | $2,558 |
| Cigna | Commercial|PPO | $2,558 |
| Blue Shield CA | Commercial|All Other Plans | $2,641 |
| Aetna | Commercial|All Other Plans | $2,806 |
| Aetna | Commercial|HMO | $2,806 |
| Aetna | Commercial|PPO | $2,806 |
| Kaiser | Commercial|All Plans | $2,889 |
| HPN | Commercial|All Plans | $3,177 |
| MultiPlan | Commercial|All Plans | $3,301 |
Inpatient
$1,733cash price (self-pay)
$4,127list price
$2,822–$4,222range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser | Commercial|All Plans | $2,889 |
| MultiPlan | Commercial|All Plans | $3,301 |
| SMIPA | Medicare|All Plans | $4,127 |
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